分期注射法在经皮椎体成形术中的应用  

Application of phased injection in percutaneous vertebroplasty

作　　者：刘鹤飞[1] 田庆华[1] 易飞[1] 王涛[1] 吴春根[1] LIU Hefei;TIAN Qinghua;YI Fei;WANG Tao;WU Chungen(Department of Interventional Radiology, Affiliated Sixth People's Hospital,Shanghai Jiaotong University, Shanghai 200233, China)

机构地区：[1]上海交通大学附属第六人民医院放射科,200233

出　　处：《介入放射学杂志》2018年第12期1163-1167,共5页Journal of Interventional Radiology

基　　金：上海市自然科学基金面上项目(18ZR1429400)

摘　　要：目的探讨经皮椎体成形术(PVP)中分期注射法对于脊柱病变治疗的安全性及有效性。方法回顾性分析228例患者,443节手术椎体,根据手术方法的不同将患者分为两组:A组(采用分期注射法)和B组(无分期注射法),所有患者随访12个月,随访过程中采用视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI)评价临床疗效,采用统计学方法对随访数据进行统计学分析。结果所有患者顺利完成手术,A组患者每节椎体骨水泥注入量平均(4.75±0.85) m L,B组患者骨水泥注入量平均(4.23±1.16) m L,A组患者81节椎体(23.9%)发生骨水泥渗漏,B组患者36节椎体(34.6%)发生骨水泥渗漏,骨水泥渗漏周围组织,未引起明显不适。对随访数据进行统计学分析显示,A组术后1 d和1个月VAS及ODI评分优于B组,差异有统计学意义,但是A组与B组术后6和12个月VAS及ODI评分差异无统计学意义。结论 PVP是治疗椎体病变安全有效的方法,为达到解剖学上的修复,从而最大程度恢复脊柱稳定性,缓解症状,在PVP中采用分期注射法是一种安全及有效的手术方法。Objective To evaluate the safety and efficacy of phased injection in percutaneous vertebroplasty(PVP) for spinal diseases. Methods The clinical data of a total of 228 patients with spinal disease(443 surgical vertebral bodies in total) were retrospective analyzed. According to the different surgical methods, the patients were divided into Group A(using phased injection) and group B(using non-phased injection). All patients were followed up for 12 months. Visual analog scale(VAS) scores and Oswestry Disability Index(ODI) values were used to evaluate the clinical efficacy. The follow-up data were statistically analyzed by using statistical methods. Results Successful operation was accomplished in all patients. The average volume of bone cement injection in group A was(4.75±0.85) mL, which was(4.23±1.16) mL in group B. Bone cement leakage occurred in 81 vertebrae(23.9%) in group A and in 36 vertebrae(34.6%) in group B. Bone cement leaked into surrounding tissues, but it didn’t cause any apparent discomfort. Statistical analysis of the follow-up data revealed that statistically significant differences in one-day postoperative and one-month postoperative VAS scores as well as ODI values existed between group A and group B, although the differences in 6-month postoperative and 12-month postoperative VAS scores as well as ODI values were not statistically significant between group A and group B. Conclusion For the treatment of vertebral lesions,PVP is safe and effective. In order to achieve anatomical repair, restore the spinal stability and relieve the clinical symptoms to the greatest possible extent, the use of phased injection in performing PVP is safe and effective.

关 键 词：分期注射法 椎体病变 经皮椎体成形术 脊柱稳定性 解剖修复 

分 类 号：R681.53[医药卫生—骨科学]